Patients Medication List Drug/ Dose Route Classification Chew ASA Tab 81 PO Major mg Antipyretics, nonopiod analgesics, salicylates

Exelon 95mg/24 hour Patch Cholinesterase inhibitor

Freq 1 Daily

Times Given 0900

Mechanism of Action Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation. Centrally acting, selective, long-acting reversible cholinesterase inhibitor, causes elevated acetylcholine levels in the cortex which slows the neuronal degradation that occurs in Alzheimers disease. Binds to opiate receptors in the CNS. Alter perception of and response to painful stimuli while producing generalized CNS depression: suppress the cough reflex via a direct central action. Depresses CNS probably by potentiating GABA, an inhibitory neurotransmitter.

Patient Rational Hypertension, osteoarthritis

Side Effects GI bleeding, dyspepsia, epigastric distress, nausea, anaphylaxis and laryngeal edema Weakness, dizziness, anorexia, nausea, vomiting, diarrhea, tremor, sedation (unusual), h/a, weight loss, fever

Nursing Implications Assess pain and limitation of movement, note type, location & intensity before and at the peak after admin. Monitor for onset of tinnitus, h/a, hyperventilation, agitation, mental confusion, lethargy, diarrhea and sweating. Determine if patient has allergy to rivastigmine, pregnancy, lactation, sick sinus syndrome, GI bleeding, seizures, asthma, COPD, Asses for orientation, affect, BP, Pulse, abdominal exam, renal and liver function tests

Safe Yes

95 mg

Derm al

1 Daily

0900

Alzheimers Disease, Dementia

Yes

Hydrocodone APAP 50325 amneal norco Opiod analgesics, opiod agonists/ nonopiod analgesic combinations Lorazepam Watson Ativan Analgesic adjuncts, antianxiety agents, sedative/ hypnotics, benzodiazepines

5325 mg

PO

1 twice Daily

0900 1900

Osteoarthritis

Confusion, dizziness, sedation, hypotension, constipation, dyspepsia, nausea, risk for physical dependence Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST, h/a, slurred speech, hypotension, physical dependence

Assess BP, P, & R before and periodically during admin. If respiratory rate is <10/min assess level of sedation. Assess type, location, and intensity of pain prior to 1 hr (peak) following admin. Assess cough and lung sounds. Assess bowel function routinely, increase fluids to reduce risk of constipation. NARCAN (naloxone) is the antidote required to reverse respiratory depression or coma. Focus on comatose patients, pre-existing CNS depression, uncontrolled severe pain, narrow-angle glaucoma, severe hypotension, and pregnancy. Assess for anxiety, status epilepticus, vital signs before and after admin. Do not give this medication to patients who are suffering from apnea or cardiac arrest.

Yes

0.5 mg

PO

1 Daily

0900

Dementia

Yes

Patients Medication List Drug/ Dose Route Classification Sertraline HCL 50 PO cambe Zoloft mg Antidepressants, selectvie serotonin reuptake inhibitors (SSRIs)

Freq 1 Daily

Times Given 0900

Mechanism of Action Inhibits neuronal uptake of serotonin in the CNS, thus potentiating the activity of serotonin. Has little effect on norepinephrine or dopamine.

Patient Rational Dementia, depression

Side Effects NEUROLEPTIC MALIGNANT SYNDROME, SUICIDAL THOUGHTS, dizziness, drowsiness, fatigue, h/a, insomnia, diarrhea, dry mouth, nausea, sexual dysfunction, ^sweating, tremor, SEROTONIN SYNDROME Drowsiness, constipation, nausea, vomiting, dry mouth, nausea, vomiting, dizziness, abd pain/distention/ discomfort.

Nursing Implications Assess for suicidal tendencies especially during early therapy. Monitor appetite and nutritional intake. Weigh weekly. Assess for serotonin syndrome (mental changes [agitation, hallucinations, coma]), autonomic instability [tachycardia, labile BP, hyperthermia], neuromuscular aberrations [hyper-reflexia, incoordination] and/or GI symptoms [nausea, vomiting, diarrhea]. Monitor mood changes for depression. Assess for frequency of OCD behaviors. Assess for frequency and severity of panic attacks. Assess for symptoms of social anxiety disorder.

Safe Yes

Immodium A-D loperamide HCL

2mg

PO

Antidiarrheals

PRN 1 tab after each diarrh ea stool x 24 hours PRN

Lorazepam Watson Ativan

1mg

PO

Inhibits GI peristaltic activity by direct action on circular and longitudinal muscles. Prolongs transit time of intestinal contents, increases consistency of stools, and reduces fluid and electrolyte loss. Depresses CNS probably by potentiating GABA, an inhibitory neurotransmitter.

Diarrhea

Notify Dr. if diarrhea doesnt stop in a few days if abd pain, distention, or fever develops. Record number and consistency of stools. Do not take with alcohol or other CNS depressants as they may increase drowsiness. Educate patient on how to relieve dry mouth, rinse mouth with water frequently, suck on hard candy.

Yes

Dementia

Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST, h/a, slurred speech, hypotension, physical dependence

Focus on comatose patients, pre-existing CNS depression, uncontrolled severe pain, narrow-angle glaucoma, severe hypotension, and pregnancy. Assess for anxiety, status epilepticus, vital signs before and after admin. Do not give this medication to patients who are suffering from apnea or cardiac arrest.

Yes

Patients Medication List Drug/ Dose Route Classification Med Pass 3 oz PO Supplement Nutritional Supplement

Freq TID

Times Given 0900 1300 2100

Mechanism of Action Provides calories and protein without reducing appetite for meals

Patient Rational Used to administer medications and supplement nutrition Constipation, neurologic constipation

Side Effects Can cause upset stomach and allergic reactions, nausea, rashes, flushing, sweating & headaches Cramping, diarrhea, electrolyte abnormalities, laxative dependence, pink-red or brown-black discoloration of urine

Nursing Implications Determine if pt is allergic to ingredients, record amount consumed as percentage

Safe Yes

Senexon-S Tablets Rugby Laxatives Stimulant laxatives

PO

2 BID

0900 1700

Milk of Magnesia Magnesium HCL Laxatives Zofran ondansetron HCL Antiemetics 5-HT3

PRN

4mg

PO

1 tab q6h as neede d x 72 hours

Stomach/abd pain or cramping, nausea, diarrhea, weakness. Reddish-brown urine. Muscle cramps/weakness, irregular heartbeat, dizziness, decreased urination, mental/mood changes (confusion), nausea, vomiting, diarrehea Essential for the activity of many enzymes. Are osmotically active in GI tract, drawing water into the lumen and causing peristalsis. Blocks effect of serotonin at 5-HT3 receptor sites (selective antagonist) located in vagal nerve terminals and the chemoreceptor trigger zone in the CNS.

May discolor urine or feces, monitor I&O

Laxative

Diarrhea, flushing, sweating

Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool produced.

Yes

Vomiting

TORSADE DE POINTES, h/a, constipation, diarrhea, abd pain, dry mouth, fatigue, weakness, dizziness, ^ liver enzymes

Assess patient for nausea, vomiting, abd distention, and bowel sounds prior to and following admin. Assess patient for extrapyramidal effects (involuntary movements, facial grimacing, rigidity, shuffling walk, trembling hands) periodically during therapy. Monitory ECG patients with hypokalemia or hypomagnesemia, HF, bradarrhythmias, or patients taking concomitant medications that prolong the QT interval.

Yes